Eating disorder clinic expands to Worcester, beyond

Laura Roias, the program director at Walden Behavioral Care LLC of Waltham, which provides comprehensive programs for treating eating disorders.

When Cheryl Kerrigan was 5 she went trick-or-treating on Halloween, like most young children do.

But unlike other children, Ms. Kerrigan viewed Halloween not for its treats but for its tricks. The trick was to find a piece of candy that was “safe” to eat.

Peppermints were safe. Snickers, not safe.“Snickers would make you fat,” she explained.

As that list of “safe” foods grew shorter during her teens, Ms. Kerrigan was diagnosed as having anorexia.

Anorexia — as a disease — is the most lethal of all psychiatric illnesses, according to Stuart L. Koman, president and chief executive of Walden Behavioral Care LLC of Waltham, one of the country’s leading comprehensive programs for treating eating disorders.

“About 20 percent of anorexic patients die either because their physical condition declines so badly or because they take their own lives,” said Mr. Koman. “It’s a terrible way to live; it’s heartbreaking.”

Food — and constant lies to family and friends as to why she was not eating — continued to dominate Ms. Kerrigan’s life, even as she graduated with honors from Regis College and started down a career path, eventually becoming assistant treasurer and business office manager at Commonwealth Capital Ventures in Waltham.

At 38, however, confronted by family intervention, she began to face the fact that she was seriously ill and needed expert help, eventually seeking treatment at Walden, where patients with eating disorders are treated, whether they are anorexic, bulimic or are binge eaters.

Anorexics eat nothing or little at all; bulimia patients control their weight by vomiting after meals. At the other end of the scale are those whose binge eating leads to obesity. Some even undergo bariatric surgery, but return to their destructive habit afterward.

In 2003, Mr. Koman set up the behavioral care program on the fifth floor of the former Waltham Community Hospital with 22 beds for patients with eating disorders and another 23 beds for those with psychiatric problems. “You have a totally structured program,” said Mr. Koman, noting that there is no other 24-hour hospital program in New England dedicated to treating those with eating disorders. “In the hospital, we see the most difficult patients,” he said, including those with heart arrhythmia, dehydration and hypertension. Others who are physically stable have integrated psychiatric care with continuing medical care.

Walden also leases 12 apartments in a development on the former hospital parking lot for a “step-down” residential program that involves 18 beds — 12 for adults, six for adolescents.

Patients learn to deal with food, not as an enemy, but as part of everyday life. Patients plan menus, shop for groceries, cook the meals — and eat them.

“You have to become able to deal with food directly — and that’s a very big part of actually getting better,” said Mr. Koman.

Patients usually stay for two to four weeks and may go onto one of Walden’s outpatient clinics, which are staffed by a psychiatrist or a nurse practitioner, a nutritionist, a social worker and a psychologist as well as administrative support.

“We’re interested in providing continuous treatment which has depth,” said Mr. Koman. “One level builds on the previous, building on the same philosophy of treatment that you have already been exposed to. We’re going to keep going until we hopefully get you graduated.”

With one outpatient clinic in Waltham, Walden added a second in Northampton; then opened a third clinic in Worcester in 2010, at the urging of Suzanne Y. Lewandowski, the academic secretary at Assumption College.

Ms. Lewandowski, whose own 30-year battle with binge eating and bulimia almost killed her several times before she fully recovered in 1999, started an eating disorders support group in 2004, but then discovered there were only one or two eating disorder professionals in Worcester County from whom members could get help. Most resources were in Boston.

According to Mr. Koman, Walden does not set up outpatient clinics in areas where there are other clinics, even though patients are referred to Walden from all over New England.

Since services were lacking in Worcester County, Walden opened a clinic in 2010 in the former Tatnuck Bookseller building on Chandler Street, then recently expanded it from 500 square feet to 2,400 square feet because of the demand for services.

Braintree became the fourth clinic, and most recently Walden partnered with Eastern Connecticut Health Network to set up a clinic in South Windsor, Conn.

Walden employs about 200 people, with 140 in Waltham and another 10 to 15 employees in each of the clinics. On an average day, the staff sees about 120 patients. Hospitalization runs about $1,000 a day. Some patients pay privately, but most are covered through private insurance plans, as well as the state insurance plan, MassHealth.

The highest percentage of patients are 25 to 40 years old, but can start as young as pre-teenagers. Young patients are of particular concern, according to Mr. Koman, because they are likely to miss developmental milestones.

But, there is no upper age limitation at Walden.

“We have quite a few patients who have been struggling with their eating disorder for many, many years,” said Mr. Koman.

As for taking back their lives, Mr. Koman said he divides patients into thirds.

One-third get treatment and just grow out of it and recover fully.

About one-third will have an eating disorder, get treatment, make progress and cope with it all of their lives, as it comes and goes.

Another third get stuck in it and have an eating disorder that is long-term and really debilitating.

Ms. Kerrigan falls into the more successful category. In fact, she now mentors other patients at Walden, speaks regularly at schools and other venues and has written a book.